Several types of surgical devices are commonly used to cut and occlude tissue to control bleeding or leaking during or after dissection. These include surgical staplers, electrosurgical ligators, electrocautery instruments, blades, hooks, scissors and high frequency vibration ligators such as harmonic scalpels.
In particular, the linear surgical stapler is very useful and popular. The linear surgical stapler generally comprises an anvil surface against which staples are fired from an oppositely located cartridge. Tissue is captured in a gap between the jaw-like anvil and cartridge. A plurality of staples arranged in parallel rows in a staggered fashion is fired into the tissue and a blade operates to cut tissue between two sets of staple rows. Generally, the stapler is a single fire device and it must be reloaded with staple-cartridges during use. Most surgical procedures require the use of multiple cartridges. The stapler is designed to work only with a new staple cartridge in place and has a safety lock to prevent actuation of the blade if no new staple cartridge is present. The individual staple-cartridges are expensive. The cost may be justifiable for use in actual surgery but it is prohibitive in the case of training or practice.
Examples of energy-based surgical instruments include electrosurgical blades, probes, scissors, graspers, dissectors, electrocautery instruments and the like. Generally, electrosurgery is performed using an electrosurgical generator connected to an alternating current power supply and an instrument including one or more electrodes. Voltage is provided by the generator and high-frequency electric current is delivered to biological tissue through the electrode tip of the instrument or hand piece as a means to cut, coagulate, desiccate or fulgurate tissue. As the current is delivered, it passes through and heats the tissues to create the desired clinical effect. Alternatively, the electrical current is used to heat an instrument and a clinical effect is realized when the heated instrument is applied to tissue as in electrocautery. Additionally, many procedures make use of energy devices that are based on high frequency sound also known as ultrasound devices. These and other energy-based instruments advantageously provide a surgeon with the ability to make precise and nearly effortless cuts, dissect tissue with nearly instant thermal hemostasis limiting blood loss. Such instruments have become a standard within the surgical community and are used regularly in a variety of procedures.
Because of the effectiveness of electrosurgical and other energy-based instruments and procedures, it is important to train the clinician in the use of energy-based surgical instruments and procedures. Many of the existing training or simulating modules use live tissue from animals or cadavers. Real live tissue may be expensive and difficult to obtain, requires preservation using refrigeration and generates a smoke plume and odor when cauterized. With real tissue, a grounding plate is attached to an electrosurgical generator and the grounding plate is placed underneath the patient so that the current penetrates deeper into the tissues. In general, the practice of electrosurgical techniques using real tissue requires additional safety considerations. Since in the case of energy-based ligation, the devices are designed to operate only on conductive tissue, it is not always practical to use live tissue or cadaver in training or practice programs.
Therefore, there is a need to provide an inexpensive and practical way to train operators in the use of cutting and occlusion procedures such as surgical stapling and energy-based ligation. Also, there is a need to provide surgical training instruments that mimic the function of stapling and energy-based surgical instruments when used on elastomeric artificial tissue models.